Correlation Analysis of the Anatomical Structures Related to Maxillary Sinus Augmentation

Aims: Preoperative evaluation of maxillary sinus anatomy is crucial to minimize procedural complications. The aim of this study was to assess the anatomical structures associated with sinus augmentation and investigate the correlation between these structures. Materials and Methods: This retrospective study included cone-beam computed tomography scans of patients referred for the reconstruction of the posterior maxilla with dental implants. The intraosseous anastomosis (PIA) and septa were evaluated on the images. Lateral wall thickness (LWT), the diameter of the PIA (DIA), the vertical distance of the PIA to the sinus floor (DSF), and sinus floor angle (SFA) were also measured. Results: A total of 250 sinuses were examined. PIA was detected in 46.8% of the sinuses. The mean SFA value was 77.11 degrees +/- 11.11 degrees (range 48.25 degrees-112.33 degrees). The LWT ranged from 0.63 to 10.23 mm with a mean value of 1.35 +/- 0.79 mm. Of 250 sinuses, 82 (32.8%) showed septa. A strong negative correlation was found between SFA and PIA detection (r = 0.98, P = 0.008), SFA and DSF (r = 0.99, P = 0.000), and SFA and septa (r = 0.98, P = 0.000). LWT showed a positive correlation with DIA (r = 0.72, P = 0.082), although not statistically significant. Conclusions: The relationships highlight the combined effect of the structures on membrane perforation. As this makes the lateral window approach more problematic, the surgeon may seek minimally invasive approaches. Moreover, the strong correlation of SFA-PIA-DSF may significantly affect graft vascularization and needs to be evaluated with clinical studies.